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Case 86: Leg ulceration

This patient has had trouble with leg swelling for some time.

1. What process has caused this appearance?

Chronic lymphodema

2. What complication has then occurred?

Skin ulceration in an area of skin hyperkeratosis. This would most likely be simple ulceration, however an SCC developing in an area of chronic irritation (Marjolin's Ulcer) is a possibliity - this should be biopsied.

New England Journal of Medicine - images in clinical medicine - Marjolin's Ulcer

Lymphoedema: Pathophysiology and management